Anxiety, Depression, and Disease Burden in Idiopathic Subglottic Stenosis

Idiopathic subglottic stenosis (iSGS) is a chronic, debilitating condition leading to significant changes in quality of life This study aims to describe the comorbidity of anxiety/depression symptoms and iSGS.

Patients with iSGS were surveyed using verified measures of physical symptom severity and mental health status, including the Dyspnea Index (DI), Voice Handicap Index (VHI), General Anxiety Disorder-7 scale (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Rosenberg Self-Esteem Scale (RSE), and Short Form-12 (SF-12).

Twenty-seven iSGS patients completed surveys (27/66, 40.9%). All but one were female, and the mean age was 53.8 (range 35-73). A total of 70 surgeries had been performed for treatment of iSGS, with a mean of 2.8 surgeries per person (range 0-15). Fourteen patients (51.9%) reported that iSGS impacts their ability to complete activities of daily living. Thirteen patients (48.1%) reported an impact on their ability to communicate. The mean patient-reported impact level of iSGS on anxiety/depression was 25.5/100. The mean PHQ-9 score was 5.6 in the overall cohort and 9.5 in those with diagnosed or suspected depression/anxiety. The mean GAD-7 score was 4.7 for the overall cohort and 8.3 for patients who reported a suspected or diagnosed mental health condition. DI and GAD-7 scores were mildly positively correlated (r ²  = 0.23), as well as DI and PHQ-9 scores (r ²  = 0.30).

This study demonstrates a small association between symptoms of anxiety, depression, and idiopathic subglottic stenosis. Providers should have a low threshold for administering mental health screening tools and making psychology referrals when needed. Level of Evidence: III.